Provider Demographics
NPI:1619313236
Name:OSTEOPATHIC INTEGRATIVE MEDICINE
Entity Type:Organization
Organization Name:OSTEOPATHIC INTEGRATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAROU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-350-7990
Mailing Address - Street 1:70 BROADWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-5937
Mailing Address - Country:US
Mailing Address - Phone:303-350-7990
Mailing Address - Fax:
Practice Address - Street 1:70 BROADWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-5937
Practice Address - Country:US
Practice Address - Phone:303-350-7990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40470204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty